Healthcare Associated Infections

Question 1

Why are HCAI’s important?

Answer 1

Cover any infection caused by any infectious agent acquired either as a direct
result of healthcare interventions such as medical or surgical treatment, or from
being in contact with a healthcare setting.
➢ High morbidity and mortality
➢ 300,000 patients/year in England
➢ £1 billion/year
➢ Additional use of NHS resources, greater patient discomfort + decrease in
patient safety

Question 2

Patient groups at risk of HCAIs

Answer 2

Cytotoxic drugs and steroids
➢ Antibiotics
➢ HIV and other immunosuppressing virus infection
➢ Underlying disease – diabetes, renal failure
➢ Trauma – burns
➢ Surgery, urinary catheters, peritoneal dialysis

Question 3

General HCAIs predisposing factors

Answer 3

Very young and old
➢ Immunocompromised
➢ Use of broad spectrum of antibiotics
➢ Invasive procedures, surgery
➢ Indwelling medical devices
➢ Extended length of stay in healthcare setting

Question 4

Reservoir of infection
1. Endogenous

Answer 4

Patient own flora
❖ Residing on the patient’s skin, mucous membranes, gastrointestinal tract, respiratory
tract

Question 5

Reservoir of infection
2. Exogenous

Answer 5

Another person – staff, visitor, patient
❖ Airborne dissemination
❖ Others: environment, catheters

Question 6

Infections commonly acquired in hospitals

Surgical wound infection

Answer 6

Staphylococci, Enterococci, E. coli, P. Aeruginosa

Question 7

Infections commonly acquired in hospitals

Respiratory Tract Infection

Answer 7

b) S. aureus, P. aeruginosa

Question 8

Infections commonly acquired in hospitals

UTI

Answer 8

E. coli, Candida, Enterococci

Question 9

Infections commonly acquired in hospitals

Bacteraemia

Answer 9

) Staphylococci, Enterococci, Candida

Question 10

Transmission of infections (general route)

Answer 10

Droplets
❖ Skin scales
❖ Hands & clothing of another person
❖ Clinical equipment
❖ Sterile fluids
❖ Food

Question 11

Transmission of infection (clinical)

Answer 11

❖ Direct – patient to patient
❖ Indirect
❖ Skin contact (hand)
❖ Respiratory tract – coughs + sneezes spread disease
❖ Genito-urinary route
❖ Skin barrier broken (bites, punctures, burns)
❖ Faecal – oral route

Question 12

Prevention of HCAIs

Answer 12

Exclusion of sources of infection:
❖ Staff must undergo health screening (before + throughout employment)
❖ Provision of sterile instruments, medication, intravenous fluid
❖ Food
Breaking the chain of infection:
❖ Aseptic practice by the staff
❖ Handwashing
Control of airborne transmission:
❖ Maintenance of ventilation systems (aircon, heating)
❖ Patient isolation